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<br />CA Building Energy Efficiency Standards- 2013 Nonresidential Compliance May2018
<br />No. M22176 A
<br />Exp. 12/3((17
<br />CAUEO��
<br />DATE: 01/21/2017
<br />JOB: PT -ST -05
<br />DWG BY: KS
<br />CHK BY: APV
<br />M3
<br />A. MECHANICAL COMPLIANCE FQRNR'& WORKSHEETS (check box H worksheet is Indludedj:.
<br />FdrdeEmfed instructions ori -she use of this and all Energy Efficier#[y Standards camplionc'eforms, refetti the 3023 Nontesioentldl Manual
<br />Note: The Enforcement Agency may requirTh- esignerandattachedtothisplars. Listed below are alfilreacceptaricatestsfo esforalf e olffarms to he incorporated onto the lwiidingplans,
<br />Designer -
<br />YES NO Form/Worksheet tie
<br />0 -❑ NRCC;MCH-01•E Part 1 of3}. Certificate of Compliance, Declaration, Req ufied an lansforall subrfittals_..
<br />0 ❑ RCCFMGH-QI-E:�Part2af3j. CertifitateafComp lSdnce,Requlred AccTh coritta0tir whojIustalled the equipment is responsible to eitherconduct the acoeptBricttest thermseltor have a qualified oriffityrun the fail themi, ifinore then responsibility for the acteptia nce testing, each person shall sign and subm eptatt€eTests (MEH-Q2Ata111kJ.Re uiretionpiansfnraiisubmlttaishistallinigContmicton
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<br />❑ --MCH - '. a _- -" tired ACce once Testa NICH-12ATo 19A). Required on Ions where applicable. PJ RCC. -01 E P rt 3 of 3 Certificate of Compliance, Re U
<br />1ZI ❑ NRCC«MCH-02:-E(Patt-lof 2)' Mechari[aID Equi pmeptSumma is reUired for alIsubmittalswitFiCent ralAlrSystems- li'iso IonalQn lens. I IT
<br />MechantalWet Epu7pment5ummaryisreq uired foralfsubmittalswith chi] ledwater,hot waterorcondenserwater
<br />ID ❑ NRCC-MCH-02-E:(Part2of 21' stems.at i5a Tonal on tans.
<br />sy P1 P
<br />p] -❑ NRCC-MCH-Q3'-E
<br />Mechanical Ventilation and Reheat Is req u�fed for all submittals wllhrnultlple zone heating and cooling systems. Ills
<br />optionalonpians-
<br />121' ❑ NRCC-MCH-07-E(Pattl of 2), Rower G011SUm tion -of Fans. Rewired OM Pahs whereaphcable
<br />D ❑ NRCC=MCN-07-E(I+att2of2)
<br />DQLUMENTATIQN AUTHOR'€DE(XARATiDN STATEMENT
<br />LL z
<br />tifrcate of Compliahte donanentatronisatt¢rateand wmpfeie:
<br />1 !certify that this CerLO
<br />DocumenlatlRn A[Ihv NamR. KRISHNA KUMAR P.E.
<br />: e.t/. „„h,✓
<br />Dacunent2rwn autharsignature:
<br />:ecce nde reds theta I land iisfail ui mnttirafre Uiresanacce bnee:taat:Alfie u( f
<br />RRY. esl..prA 9 p 9 PiT[eM'o thmsarnetypmfhatTequ€resatmsk,:RstfhmegU�gfimntdescripdonandthenumhmrafsysterns.
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<br />f6rnpany:
<br />KK Engg.
<br />Siitroture Uate; ..
<br />1/18/2417:.
<br />" d�"� 3877 DWIGGINS ST.
<br />r�wRfRseeutmtlaniarnnr�uongaaPPllc.filet: M22176
<br />dalsmminFd:.
<br />LOS ANGELES, CA 90063
<br />714 742-4560
<br />RESPONSBLE PERSQN'S DECLARATION SCATEMENT'
<br />Icertifythe followingunder penalty of psi Jury, underthelaws o'ttfie State ofCahforma:
<br />L The information provided on this Ceraficata of Campiianceis trueaM cerrc:.t.
<br />Z- I am eligible under Division 3 afthe Busfiess and Professions Cede to accept responsibdity #drthe 6uildmgtiesign or System design derdified On fhfs CertificaTe bf Complwrice {responsible
<br />-
<br />designer}.
<br />3.. The ens features and'erformanees ectficaUons-materials ddm onan and manufactured devlcesfdrthe hWldlA des! ors 'tem deli :ids tiled till a flcate `ta :
<br />p ts, n m on s c ru of Cam I nee
<br />t'gy P P % gn ys B P
<br />conformtO-.the requlrerhen4c of Tide.24, Part 1 and Part 4 of the:Cahfnrnta Code of Regulations.
<br />-A The buildilfg design#eatures ar systenl:design#eaLrtrEs identifiedtrnthis Certiiirate o#Comp"Rance are con5lskentwiththe mformadatlproWded or)=oTher applicable cmnplr2ltt!e documerit�
<br />worksheets; calculadonS, plans and spatiflcadona s0hmitted tO tfie enfgrcenent agency for approval wttN'this building`permit apphCaflon.
<br />5.. I will ensure that a completed signed ;copy ofthis Certificate of:[Ompllanee dull be made available wlthtiie,hullrYngpermi[(s) issued for the buildNSg, antl made:availabletbthe enfaxcerrieOt
<br />e for -all e B able fn tions, to erstand t. at a €om 1 to sl ned o f this C Ifl ate (Com 11 n e is r wired t b 1 1 d
<br />afx ^c'/ ,� PRC ..SPeC nd h pE...d g c pYa ert c o ,p a C eq_,. o encu edw(ih the documeniatlon the huilder provides iothe
<br />building owner atoccupancy.
<br />ReSPmsiEleoesigneename: KRISHNA KUMAR P.E.
<br />0.eipansmle 6esignar signature: ,✓.,,,•.
<br />DGgnasdcS for Au&
<br />HVAC ar heat Pum Theamost s
<br />p at 1t0, ti,11A2
<br />codwa�;: KK ENGG.
<br />6a�5grg& 01/18/2017
<br />Address: :.
<br />3877 DWIGGINS ST.
<br />Licetue:
<br />M22176
<br />°"!5`axFnlP` LOS ANGELES, CA 90063
<br />r�m� 714-742-4560
<br />Systems Controls
<br />Concentration (151is
<br />'
<br />PowerEonsumptlonofFans,De€Iaratitm.It2�quiredan(7}answhQreaPPlicable
<br />DQLUMENTATIQN AUTHOR'€DE(XARATiDN STATEMENT
<br />LL z
<br />tifrcate of Compliahte donanentatronisatt¢rateand wmpfeie:
<br />1 !certify that this CerLO
<br />DocumenlatlRn A[Ihv NamR. KRISHNA KUMAR P.E.
<br />: e.t/. „„h,✓
<br />Dacunent2rwn autharsignature:
<br />:ecce nde reds theta I land iisfail ui mnttirafre Uiresanacce bnee:taat:Alfie u( f
<br />RRY. esl..prA 9 p 9 PiT[eM'o thmsarnetypmfhatTequ€resatmsk,:RstfhmegU�gfimntdescripdonandthenumhmrafsysterns.
<br />n�
<br />f6rnpany:
<br />KK Engg.
<br />Siitroture Uate; ..
<br />1/18/2417:.
<br />" d�"� 3877 DWIGGINS ST.
<br />r�wRfRseeutmtlaniarnnr�uongaaPPllc.filet: M22176
<br />dalsmminFd:.
<br />LOS ANGELES, CA 90063
<br />714 742-4560
<br />RESPONSBLE PERSQN'S DECLARATION SCATEMENT'
<br />Icertifythe followingunder penalty of psi Jury, underthelaws o'ttfie State ofCahforma:
<br />L The information provided on this Ceraficata of Campiianceis trueaM cerrc:.t.
<br />Z- I am eligible under Division 3 afthe Busfiess and Professions Cede to accept responsibdity #drthe 6uildmgtiesign or System design derdified On fhfs CertificaTe bf Complwrice {responsible
<br />-
<br />designer}.
<br />3.. The ens features and'erformanees ectficaUons-materials ddm onan and manufactured devlcesfdrthe hWldlA des! ors 'tem deli :ids tiled till a flcate `ta :
<br />p ts, n m on s c ru of Cam I nee
<br />t'gy P P % gn ys B P
<br />conformtO-.the requlrerhen4c of Tide.24, Part 1 and Part 4 of the:Cahfnrnta Code of Regulations.
<br />-A The buildilfg design#eatures ar systenl:design#eaLrtrEs identifiedtrnthis Certiiirate o#Comp"Rance are con5lskentwiththe mformadatlproWded or)=oTher applicable cmnplr2ltt!e documerit�
<br />worksheets; calculadonS, plans and spatiflcadona s0hmitted tO tfie enfgrcenent agency for approval wttN'this building`permit apphCaflon.
<br />5.. I will ensure that a completed signed ;copy ofthis Certificate of:[Ompllanee dull be made available wlthtiie,hullrYngpermi[(s) issued for the buildNSg, antl made:availabletbthe enfaxcerrieOt
<br />e for -all e B able fn tions, to erstand t. at a €om 1 to sl ned o f this C Ifl ate (Com 11 n e is r wired t b 1 1 d
<br />afx ^c'/ ,� PRC ..SPeC nd h pE...d g c pYa ert c o ,p a C eq_,. o encu edw(ih the documeniatlon the huilder provides iothe
<br />building owner atoccupancy.
<br />ReSPmsiEleoesigneename: KRISHNA KUMAR P.E.
<br />0.eipansmle 6esignar signature: ,✓.,,,•.
<br />DGgnasdcS for Au&
<br />HVAC ar heat Pum Theamost s
<br />p at 1t0, ti,11A2
<br />codwa�;: KK ENGG.
<br />6a�5grg& 01/18/2017
<br />Address: :.
<br />3877 DWIGGINS ST.
<br />Licetue:
<br />M22176
<br />°"!5`axFnlP` LOS ANGELES, CA 90063
<br />r�m� 714-742-4560
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<br />CLiHuikiing Energy tMitiency Standards lai3Nanreaderaral"Conarlarae. MnM2035
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